The complete or partial detachment of ligaments, tendons or other soft tissues from their associated bones within the body are relatively commonplace injuries. Such injuries are generally the result of excessive stresses being placed on these tissues. By way of example, tissue detachment may occur as the result of an accident such as a fall, overexertion during a work-related activity, during the course of an athletic event, repetitive stress, or in any one of many other situations and activities.
In the case of a partial detachment, the injury may heal itself, if given sufficient time and provided that care is taken not to expose the injury to further undue stress. In many cases, however, surgery may be needed to reattach the soft tissue to its associated bone or bones. Numerous devices are currently available to reattach the soft tissue to bone. Examples of currently available devices include screws, staples, tacks and suture anchors.
In soft tissue reattachment procedures utilizing suture anchors, one or more anchors, each bearing one or more strands of suture, are deployed in the bone in the desired area of tissue reattachment. The suture may be mounted to the suture anchor by passing through an eyelet associated with the suture anchor, about a portion of the suture anchor, or by in another conventional manner. Free ends or loops of the suture are passed through or around the soft tissue and are used to tie or otherwise secure the soft tissue to the bone. A surgical needle is typically mounted to one end of each suture strand to facilitate passage of the suture through tissue.
Complex or extensive surgical repairs may require the use of several suture anchors and up to several times as many free suture ends. In these procedures, tracking of individual suture strands and their relationship to one another, that is, suture management, can present particular challenges for a surgeon, particularly since such procedures are often arthroscopically performed using remote visualization. The surgeon must be able to identify which suture ends are associated with each suture anchor and with each other, to properly execute a repair and to ensure that a suture is not accidentally demounted from an anchor. In arthroscopic repair procedures, suture management can be particularly difficult because the visibility of the anchors at the surgical site, and of the sutures associated with the anchors, may be very limited. In addition, simply the presence of a large number of suture strands extending from a surgical site can result in physical and visual clutter, further increasing the difficulty of the surgical procedure for the surgeon, and presenting a risk of tangling sutures. Color-coding or otherwise visually marking sutures for identification is known in this art, but can provide only limited relief of these suture management issues, particularly when a required type of suture is available in only a very limited number of visually distinct colors or patterns, and several similarly loaded multi-suture anchors are deployed during a procedure. In addition, visual coding of sutures by itself does not reduce physical or visual clutter associated with a multiplicity of sutures deployed at the surgical site. Yet another factor is the speed and efficiency in which the procedure is performed. The patient is typically best served by being under anesthesia for the shortest possible period of time. Difficulties in managing sutures can complicate and prolong the duration of a procedure.
Accordingly, there remains a need for improved methods and devices for managing sutures in surgical procedures for repairing soft tissue to bone.